EmailMe Form - SCFF Local Food Membership Application(2)

Name - Primary Contact

First Last

Market Name

Address - please note this information may be published on our website and the Local Food Map

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please provide detailed verbal directions to your Business/Market. (i.e. 1 km north of Hwy. 400 on Hwy 93)

Phone

### - ### - ####

Email - this information will be published on our website and Local Food Map

Alternate email - for internal use only

Web Site

Facebook Page

Twitter Handle

Instagram

Business/Market Information for printed map and website listings: List food/beverage products (for human consumption).
Simcoe County Farm Fresh reserves the right to edit submissions and choose what information will be published.
Simcoe County Farm Fresh is not responsible for any errors or omissions.

Please indicate (check all that apply)

Wheelchair Accessible

Able to accept bus tours

Public Washrooms

Call ahead only

Hours of Operation (including Months, Days and Time)

Please write a one sentence tag line for the website listing. This can be used to highlight a special event or product. (i.e. “Season Opening Special” or “Join us for our annual Blueberry Festival!”)

Special events (if you would like your special event for 2016 mentioned in the “Upcoming Events” section on the www.simcoecountyfarmfresh.ca website please indicate what, where, and when.

Questions to determine qualifications of Member Group (Farmers’ Market/Local Food Retailer) Please note: Members in this category must be able to produce evidence that they are meeting the qualifying criteria, if requested, by the association. Members are encouraged to source from other members of the association where possible.

	Yes	No
Is your market/ business located within Simcoe County? (If located outside of the County, acceptance of membership will be at the discretion of the Board of Directors)
Are you committed to sourcing and selling local food/beverages?
For Farmers’ Markets - Are a minimum of 51% of the vendors farmers/producers?
For Local Food Retailers – Is there a target of at least 25% of the food/beverage products offered for sale from Simcoe County?
Do you demonstrate your commitment to sourcing and selling local food/beverage to your customers by: Listing your farm partners on your web site, within your establishment? Training your staff? Educating your customers?
Will you be an active and engaged member of Simcoe County Farm Fresh Marketing Assoc.?
Will you act as a champion of local food/beverage in your community?

Membership Fees

Farmers' Market/Local Food Retailer Membership - $195.00 + HST = 220.00

Additional Listing - $100.00 each + HST = 113.00

Please indicate if you DO NOT want to be included in the 2016 printed version of the Local Food Guide Map

No, I do not wish to be included in the printed version of the Local Food Guide Map

Please indicate Method of Payment - Note: Payment MUST be received by March 1, 2016 in order to receive a listing in the 2016 Local Food Guide Map (printed version) Please note, if you select Credit Card you will be emailed an invoice which you can pay directly from

Visa

Mastercard

E-transfer - send to scfarmfresh@gmail.com

Cheque - make payable to Simcoe County Farm Fresh

I (please print your name)

certify and accept responsibility for ensuring the above information is correct and will be adhered to. I agree to the minimum standards / code of ethics and responsibilities as stated. I also give permission for my personal information listed above to be used for the purpose of publishing a directory of Simcoe County Farm Fresh members.
This Simcoe County Farm Fresh Membership is valid between March 1, 2016 & February 28, 2017. Membership eligibility, criteria, fees and benefits will be reviewed and may be modified annually. (Please sign below - type your name if you do not have an electronic signature)